J Am Med Inform Assoc doi:10.1136/amiajnl-2013-002079
  • Brief communication

Concern about security and privacy, and perceived control over collection and use of health information are related to withholding of health information from healthcare providers

  1. Gregory N Connolly1
  1. 1Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, Massachusetts, USA
  2. 2Department of Oral Pathology, University of Ibadan, Ibadan, Oyo State, Nigeria
  3. 3Department of Community Dentistry, University of Pretoria, Pretoria, South Africa
  1. Correspondence to Dr Israel Agaku, Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA 02115, USA; iagaku{at}
  • Received 5 June 2013
  • Revised 6 August 2013
  • Accepted 7 August 2013
  • Published Online First 23 August 2013


Introduction This study assessed the perceptions and behaviors of US adults about the security of their protected health information (PHI).

Methods The first cycle of the fourth wave of the Health Information National Trends Survey was analyzed to assess respondents’ concerns about PHI breaches. Multivariate logistic regression was used to assess the effect of such concerns on disclosure of sensitive medical information to a healthcare professional (p<0.05).

Results Most respondents expressed concerns about data breach when their PHI was being transferred between healthcare professionals by fax (67.0%; 95% CI 64.2% to 69.8%) or electronically (64.5%; 95% CI 61.7% to 67.3%). About 12.3% (95% CI 10.8% to 13.8%) of respondents had ever withheld information from a healthcare provider because of security concerns. The likelihood of information withholding was higher among respondents who perceived they had very little say about how their medical records were used (adjusted OR=1.42; 95% CI 1.03 to 1.96).

Conclusions This study underscores the need for enhanced measures to secure patients’ PHI to avoid undermining their trust.

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